Let's not lose this health-care bonus

In his State of the Union talk, President Bush talked about his health-care proposal.

He was putting forth an idea that giving people who didn't have insurance tax breaks if they insured themselves would decrease the number of people without health-insurance coverage.

Before commenting on the whole proposal, one should see it fleshed out. On the surface, it just seems like another whitewash. Give a taxpayer a deduction of $15,000 per family for buying insurance. The president said nothing about what they would pay for the insurance.

There would also be a deduction for the person who got insurance coverage at work. I thought I heard flying by a proposal that the deduction would be for the person who gave up the coverage at work and went into the marketplace to buy insurance.

I hope I'm wrong.

This plan fails for one obvious reason and one, maybe more important, that's not so obvious.

The obvious reason is that there is no way that the person would come out on top financially.

Let's say you're a person paying 28 percent tax. Your saving would be about $4,200.

Unless you have a lousy plan, your boss kicks in more than that yearly for your coverage. If your premiums are taken out pretax, one would think you already get a tax break on them.

Although the plan may work for the uninsured or under insured, it doesn't seem like a financial boon for those getting insurance at work.

Now for the part that's not so obvious.

If you would be dealing directly with the insurance company, then you would be dealing in all things directly with the insurance company.

If your personnel or human services or whatever they're called is anything north of brain dead, you have an advocate in dealing with the insurance company, especially if you work for a big firm. The insurance company, not wanting to lose the account, will listen to your HR people.

For example, many years ago, I had a health-care provider who didn't like the amount the insurance company was paying for a particular service. So, the provider sent me a bill for the difference between what she thought she should be receiving and what the insurance company was kicking in.

After talking with her and getting nowhere, I brought my complaint to the HR department of my firm. The HR person called the insurance company and explained the situation. At 110 decibels.

The insurance company quickly sent a letter to the provider saying that any more such instances and the provider would be fired from the network. Since the insurer was huge, that was a real threat.

No further bills or statements were forthcoming.

You need an advocate when dealing with insurance companies, especially these days. The government has not shown itself to be that kind of advocate.

I hope I'm wrong about the president's proposal. If the president wanted to propose something like this, he should, as my grandfather liked to say, wrap it in tissue paper and toss it in the garbage.

If he does propose it, you should go out and oppose it. When you do, say hi to the guy next to you.

That'd be me.